Individual
MRS. BONNIE JEAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(800) 354-7342
Mailing address
210 N BROADWAY AVE, PARK RIDGE, IL 60068-2906
(847) 318-5622
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146008112
IL
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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